Provider Demographics
NPI:1538314711
Name:BETH ISRAEL MEDICAL CENTER
Entity Type:Organization
Organization Name:BETH ISRAEL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOTHORACIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:KAMELLIA
Authorized Official - Middle Name:RANGELOVA
Authorized Official - Last Name:DIMITROVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-844-1757
Mailing Address - Street 1:317 E 17TH ST
Mailing Address - Street 2:11 FIERMAN HALL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3804
Mailing Address - Country:US
Mailing Address - Phone:212-844-1757
Mailing Address - Fax:
Practice Address - Street 1:317 E 17TH ST
Practice Address - Street 2:11 FIERMAN HALL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-844-1757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003249-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital